	<fieldset>
		<legend>Vos coordonnées</legend>
        <p>
<?php
$civilite_id = false;
if (isset($_POST['civilite_id']))
    $civilite_id = $_POST['civilite_id'];
echo getSelect($CIVILITES, 'civilite_id', displayRequiredField() . "Civilité", $civilite_id);
?>
			<span class="error_form"><?php if(isset($errors['civilite_id'])) echo $errors['civilite_id'] ?></span>
        </p>

		<p>
			<label for="prenom"><?php echo displayRequiredField() ?>Prénom</label>
			<input type="text" id="prenom" name="prenom" value="<?php if(isset($_POST['prenom'])) echo $_POST['prenom'] ?>" />
			<span class="error_form"><?php if(isset($errors['prenom'])) echo $errors['prenom'] ?></span>
		</p>
		<p>
			<label for="nom"><?php echo displayRequiredField() ?>Nom</label>
			<input type="text" id="nom" name="nom" value="<?php if(isset($_POST['nom'])) echo $_POST['nom'] ?>" />
			<span class="error_form"><?php if(isset($errors['nom'])) echo $errors['nom'] ?></span>
		</p>
<?php if( isset($short) && !$short ): ?>
		<p>
			<label for="telephone">Téléphone</label>
			<input type="text" id="telephone" name="telephone" value="<?php if(isset($_POST['telephone'])) echo $_POST['telephone'] ?>" />
		</p>
<?php endif; ?>
		<p>
			<label for="mail"><?php echo displayRequiredField() ?>Adresse mail</label>
			<input type="text" id="mail" name="mail" value="<?php if(isset($_POST['mail'])) echo $_POST['mail'] ?>" />
			<span class="error_form"><?php if(isset($errors['mail'])) echo $errors['mail'] ?></span>
		</p>
<?php if( isset($short) && !$short ): ?>
		<p>
			<label for="message"><?php echo displayRequiredField() ?>Message</label>
			<textarea type="text" id="message" name="message"><?php if(isset($_POST['message'])) echo $_POST['message'] ?></textarea>
			<span class="error_form"><?php if(isset($errors['message'])) echo $errors['message'] ?></span>
		</p>
<?php endif; ?>
	</fieldset>
